Smoking Health Risks & Warfarin
You may already know the link between smoking and lung health, such as the development of lung cancer, but smoking is also linked to heart disease, heart attacks and stroke. Cigarette smoking health side effects account for 1 of every 5 deaths each year in the United States.1,2 It's the main preventable cause of death and illness in the United States.
Smoking also causes coronary heart disease, the leading cause of death in the United States, and can cause reduced circulation by narrowing the blood vessels (arteries).3,4
Stroke risks and heart attack risks are higher too. Once inhaled, carbon monoxide is transferred to your bloodstream. It decrease the amount of oxygen carried in the red blood cells. Carbon monoxide also increases the amount of cholesterol build-up, which can cause the arteries to harden. Strokes can be caused by bleeding from the weakened blood vessels and blockages and clots that cut off blood flow to the brain.1
The cholesterol build-up can also lead to heart disease and possibly heart attack. Nicotine can also contribute to the hardening of arterial walls, as well as an increase in blood pressure, heart rate, and narrowing of the arteries. This chemical can stay in your body for 6-8 hours after you smoke.1
According to a Report of the Surgeon General and the American Heart Association, it is never too late to quit smoking. Quitting smoking has immediate as well as long term benefits1:
- 20 minutes after quitting, blood pressure and heart rate return
- 12 hours after quitting, the carbon monoxide levels in your blood return to normal
- One year after quitting, the risk for a heart attack drops by 50%
- 3-15 years after quitting, stroke risk can fall to about the same as a nonsmoker
- After 10 years, risk for dying of lung cancer drops by half
Clinical evidence suggests that smoking may cause significant interaction with warfarin by increasing warfarin clearance, which leads to reduced warfarin effects.5
Increasing testing frequency is recommended when quitting smoking. Studies have shown that increasing testing frequency with weekly testing of INR improves patient safety and helps keep the drug in its therapeutic effective zone 6,7 Weekly testing was shown to be the most effective testing frequency.1 Medicare and many private/commercial insurance reimburse patients for weekly patient self-testing.8
- U.S. Department of Health and Human Services. The Health Consequences of Smoking: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2004.
- Centers for Disease Control and Prevention. Annual Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses—United States, 2000–2004. Morbidity and Mortality Weekly Report 2008;57(45):1226–8.
- U.S. Department of Health and Human Services. The Health Consequences of Smoking: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2004 [accessed 2012 Jan 10].
- Institute of Medicine. Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence. Washington: National Academy of Sciences, Institute of Medicine, 2009 [accessed 2012 Jan 10].
- Nathisuwan S, et al. Assessing Evidence Of Interaction Between Smoking And Warfarin: A Systematic Review And Meta-Analysis. Chest. 2011;139(5):1130-1139.
- Am J Manag Care. 2014;20(3):202-209.
- Heneghan C., et al. Self-monitoring of oral anticoagulation: a systematic review and meta-analysis. 2006. Lancet, 367, 404-11.
- Center for Medicare and Medicaid Services. Decision Memo for Prothrombin Time (INR) Monitor for Home Anticoagulation Management (CAG-00087R) [Memorandum]. Baltimore, MD. 2008.